scholarly journals Changes of intestinal microbiota in patients with HIV

2013 ◽  
Vol 94 (1) ◽  
pp. 34-39 ◽  
Author(s):  
G R Khasanova ◽  
V A Anokhin ◽  
O I Bikkinina ◽  
E N Shakhbazova ◽  
E Y Kotlyar ◽  
...  

Aim. To assess the changes in intestinal microbiota in patients with HIV. Methods. The cultures of stool samples of 317 patients with different stages of HIV [13 (4.1%) patients - with the acute infection stage (2A, 2B, 2C), 217 (68.5%) - with the stage III, 87 (27.4%) - with the stages IVA-B according to classification by Pokrovsky V.I., 2001] were examined by plating on the growth medium and further microbiologic examination. Results. Changes in intestinal microbiota were found in 94% of the patients. The decrease in the obligatory microorganisms quantity, especially in bifidobacteria (lower than reference ranges in 70.3% of patients) was the most frequent finding. Bacterial overgrowth of conditionally pathogenic biota (mainly S. aureus and Candida) was registered in 57.1% of patients. The intestinal microbiota composition did not depend on the clinical stage of HIV infection and presence of opportunistic infections, with only CD-4 count associated with the degree of intestinal microbiota changes. Conclusion. Intestinal microbiota changes are typical for patients with HIV infection at all stages of the disease regardless of opportunistic infections presence. Low CD-4 count is associated with higher severity of intestinal microbiota changes.

1987 ◽  
Vol 32 (4) ◽  
pp. 101-107 ◽  
Author(s):  
D.H. Kennedy

The wide clinical spectrum of HIV infection is reflected in the new CDC classification. Presentations range from acute infection, asymptomatic carriage and persistent lymphadenopathy through constitutional upset and neurological disease to the opportunistic infections and cancers of AIDS. AIDS is an enigmatic disease which presents special clinical diagnostic and management problems. Although any system may be affected the lungs and the brain are the most important target organs. Though the underlying disease is currently untreatable, many of the complications of AIDS are amenable to prompt therapy. Seropositive patients should be monitored to detect early signs of significant HIV disease. Skilled counselling about the avoidance of co-factors which may potentiate HIV infection, is important.


Introduction. The introduction of antiretroviral therapy has significantly improved the long-term prognosis of AIDS patients, but opportunistic infections can still be life-threatening for this population. Among them, a large group constitutes of herpesvirus infections, which are frequent manifest forms of dermatological manifestations of HIV. The researching of IL-31, as a prospective diagnostic predictor of dermatological diseases, has been actively conducted in recent years. This is due to the interest in its biological action, which extends primarily to the skin. Тhe identification of molecular targets underlying inflammatory and infectious dermatoses is promisingly for the development of new, targeted treatments. Objective: to study the role of IL-31 in the immunopathogenesis of herpesvirus infections associated with HIV infection. Research objectives: 1) to compare the levels of IL-31 in the blood serum in patients with herpesvirus skin diseases associated with HIV infection and in healthy subjects; 2) to determine the presence of a relationship between the levels of IL-31 in the blood serum and the clinical stage of the disease. Materials and methods. The study included patients with herpesvirus infection caused by HSV-1, HSV-2, VZV-3, EBV and HHV-8 associated with HIV infection and healthy individuals. Serum IL-31 levels were measured by ELISA using commercial kits (Human IL-31 ELISA Kit, Abcam, Cambridge, MA, USA). Were collected the baseline clinical characteristics, assessment of the activity of the infectious process and the degree of immunosuppression. Results. Our study involved 39 patients with herpesvirus infection associated HIV and 31 patients of the control group. In patients with herpesvirus infection against the background of HIV infection, the average level of IL-31 in the blood serum was significantly higher than that of healthy subjects. Serum IL-31 levels in patients with herpesvirus infection did not differ significantly depending on the severity of the process and the degree of immunosuppression. Conclusion. The levels of IL-31 in the blood serum of patients with herpesvirus infection were differed by statistically significant validity in comparison with similar indicators of healthy individuals, which confirms its role in the pathogenesis of infectious skin diseases.


2021 ◽  
Vol 74 (5) ◽  
pp. 1189-1195
Author(s):  
Oksana M. Chemych ◽  
Mykola D. Chemych ◽  
Anna A. Olefir ◽  
Oleh B. Berest

The aim: Is to determine the features of the HIV infection and changes in indicators of endogenous intoxication and immunoreactivity depending on the clinical stage and the level of CD4 lymphocytes. Materials and methods: 72 HIV-patients were examined. Comparison group included 40 healthy blood donors. Clinical and laboratory examination was performed. Indicators of endogenous intoxication, nonspecific reactivity and inflammatory activity were calculated. Results:Main opportunistic infections were: oropharyngeal candidiasis; tuberculosis of different localization, more often pulmonary tuberculosis; and brain toxoplasmosis (p<0,05). Indices of endogenous intoxication and immunoreactivity are important objective criteria for diagnosis. In groups where the distribution of patients depended on the level of CD4 cells – HIV (CD4≥500) and HIV (CD4≤499-200), index changes were more pronounced than in the HIV I and HIV III groups. The most significant changes in indexes were in the HIV IV clinical group and the HIV (CD4≤199) group: endogenous intoxication indexes were increased by 1,2-7,5 and 1,9-13,7 times in both groups respectively. Non-specific reactivity indexes were decreased by 1,2-1,6 and 1,3-1,6 times, respectively; nuclear index (NI) in groups was 3 and 3,4 times higher (p<0,05–0,001). Changes in indexes of inflammatory activity were observed (p<0,05-0,001). Conclusions: Main diagnosed opportunistic infections were: oropharyngeal candidiasis; tuberculosis of different localization; and brain toxoplasmosis (p<0,05). Indices of endogenous intoxication and immunoreactivity are important objective criteria for diagnosis. The most significant changes in indexes were in the HIV IV clinical group and the HIV (CD4≤199) group (p<0,05-0,001).


2019 ◽  
Author(s):  
Noureddine Sakhri ◽  
Fatima Zahra Meski ◽  
SOUMIA TRIKI

BACKGROUND Morbidity and mortality in HIV disease is due to immune-suppression leading to life-threatening opportunistic infections (OIs) during the natural course of the disease. In 2015, the HIV prevalence is low in general population and concentrated among key populations. OBJECTIVE This study aimed to assess the prevalence and CD4 correlates of OIs among adult HIV-infected patients attending antiretroviral health care in Morocco, during 2015. METHODS We conducted a cross-sectional survey among all adult PLHIV for admitted in the health care centers during 2015, who had acquired infection disease. Patients’ opportunistic infection status was determined through clinical diagnosis and laboratory investigations. CD4 count was determined using flow cytometry technique. The clinical stage of HIV was identified by the classification of Centers for Disease Control and Prevention (CDC). We collected Socio-demographic and clinical data from patients’ medical records. We performed statistical analysis by using Epi-Info 7.2.0.1 software. The appropriate test was applied, bivariate analysis was made and the differences were significant when p<.05. RESULTS 299 HIV-infected cases were included; 53% were males. The most represented age group was 25-34 years (36.1%). The mean age of the cases was 38.7 ± 16.8. The prevalence of OIs was 47.8%. Tuberculosis (65/299, 21.7%), Pneumocystis jiroveci pneumonia (40/299, 13.4%) and Oral candidiasis (22/299, 7.4%) were the most frequently observed OIs. CONCLUSIONS Tuberculosis, pneumocystis and oral candidacies were the leading OIs, encountered by HIV-infected cases. Preventive measures and early diagnosis of HIV associated to OIs are crucial.


1995 ◽  
Vol 109 (12) ◽  
pp. 1197-1199 ◽  
Author(s):  
R. B. S. Laing ◽  
P. J. C. Wardrop ◽  
P. D. Welsby ◽  
R. P. Brettle

AbstractThe immunodeficiency which results from HIV infection is associated with a range of opportunistic infections and tumours which may present with the symptoms of upper airways disease. This paper presents three cases of stridor from different causes in patients with HIV infection, all of whom recovered following treatment. The management of this problem requires consideration of the likely aetiology which, in those with advanced immunodeficiency, includes bacterial and fungal laryngitis and epiglottitis as well as rapidly growing laryngeal tumours. Recommendations for the treatment of those with HIV infection who present with severe or rapidonset stridor should include a combination of aggressive airway intervention and broad-spectrum antibacterial and antifungal agents. Laryngeal biopsy for histology and culture is particularly important for those patients who fail to respond to the aforementioned treatment.


1993 ◽  
Vol 328 (6) ◽  
pp. 393-398 ◽  
Author(s):  
Robert A. Duncan ◽  
C. Fordham von Reyn ◽  
George M. Alliegro ◽  
Zahra Toossi ◽  
Alan M. Sugar ◽  
...  

2011 ◽  
Vol 69 (6) ◽  
pp. 964-972 ◽  
Author(s):  
Indianara Rotta ◽  
Sérgio Monteiro de Almeida

The central nervous system (CNS) and the immune system are considered major target organs for HIV infection. The neurological manifestations directly related to HIV are acute viral meningitis, chronic meningitis, HIV associated dementia, vacuolar myelopathy and involvement of the peripheral nervous system. Changes in diagnosis and clinical management have changed the aspect of HIV infection so that it is no longer a fatal disease, and has become a chronic disease requiring sustained medical management. After HAART the incidence of most opportunistic infections, including those affecting the CNS, has dropped markedly. Some studies suggest that neurological involvement of infected patient occur with different frequency, depending on HIV subtype involved in the infection. Subtype C may have reduced neuroinvasive capacity, possibly due to its different primary conformation of HIV transactivating regulatory protein (Tat), involved in monocyte chemotaxis. This review focus on physiopathologic aspects of HIV infection in CNS and its correlation with HIV clades.


CNS Spectrums ◽  
2007 ◽  
Vol 12 (11) ◽  
pp. 842-850 ◽  
Author(s):  
Daniel Costello ◽  
John Davis ◽  
Nagagopal Venna

ABSTRACTWe describe three recent patients in whom evaluation of subacute, progressive encephalopathy led to the initial diagnosis of human immunodeficiency virus infection. The clinical neurological picture of a predominance of abnormalities of mental function with few elementary neurological deficits, in conjunction with a paucity of systemic symptoms and lack of evidence for prior opportunistic infections preceding the encephalopathy are notable. The cognitive, behavioral, and neuropsychiatric disturbances are described in detail to illustrate the range of manifestations of disordered mental states associated with encephalopathy in individuals with HIV infection. The importance of a comprehensive and broad-minded work-up by brain magnetic resonance imaging, cerebrospinal fluid examination, and specific microbiological tests in delineating the potential multifactorial pathogenesis of the cerebral syndromes in relation to the HIV infection is emphasized. The gratifying long-term clinical improvements in parallel with resolution of neuroimaging and other laboratory abnormalities in response, to antiretroviral drug treatment are reported.


PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259073
Author(s):  
Nadine Mayasi Ngongo ◽  
Gilles Darcis ◽  
Hippolyte Situakibanza Nanituna ◽  
Marcel Mbula Mambimbi ◽  
Nathalie Maes ◽  
...  

Background The benefits of antiretroviral therapy (ART) underpin the recommendations for the early detection of HIV infection and ART initiation. Late initiation (LI) of antiretroviral therapy compromises the benefits of ART both individually and in the community. Indeed, it promotes the transmission of infection and higher HIV-related morbidity and mortality with complicated and costly clinical management. This study aims to analyze the evolutionary trends in the median CD4 count, the median time to initiation of ART, the proportion of patients with advanced HIV disease at the initiation of ART between 2006 and 2017 and their factors. Methods and findings HIV-positive adults (≥ 16 years old) who initiated ART between January 1, 2006 and December 31, 2017 in 25 HIV care facilities in Kinshasa, the capital of DRC, were eligible. The data were processed anonymously. LI is defined as CD4≤350 cells/μl and/or WHO clinical stage III or IV and advanced HIV disease (AHD), as CD4≤200 cells/μl and/or stage WHO clinic IV. Factors associated with advanced HIV disease at ART initiation were analyzed, irrespective of year of enrollment in HIV care, using logistic regression models. A total of 7278 patients (55% admitted after 2013) with an average age of 40.9 years were included. The majority were composed of women (71%), highly educated women (68%) and married or widowed women (61%). The median CD4 was 213 cells/μl, 76.7% of patients had CD4≤350 cells/μl, 46.1% had CD4≤200 cells/μl, and 59% of patients were at WHO clinical stages 3 or 4. Men had a more advanced clinical stage (p <0.046) and immunosuppression (p<0.0007) than women. Overall, 70% of patients started ART late, and 25% had AHD. Between 2006 and 2017, the median CD4 count increased from 190 cells/μl to 331 cells/μl (p<0.0001), and the proportions of patients with LI and AHD decreased from 76% to 47% (p< 0.0001) and from 18.7% to 8.9% (p<0.0001), respectively. The median time to initiation of ART after screening for HIV infection decreased from 40 to zero months (p<0.0001), and the proportion of time to initiation of ART in the month increased from 39 to 93.3% (p<0.0001) in the same period. The probability of LI of ART was higher in married couples (OR: 1.7; 95% CI: 1.3–2.3) (p<0.0007) and lower in patients with higher education (OR: 0.74; 95% CI: 0.64–0.86) (p<0.0001). Conclusion Despite increasingly rapid treatment, the proportions of LI and AHD remain high. New approaches to early detection, the first condition for early ART and a key to ending the HIV epidemic, such as home and work HIV testing, HIV self-testing and screening at the point of service, must be implemented.


2021 ◽  
Author(s):  
Maisa Ali ◽  
Mahmoud Gassim ◽  
Nada Elmaki ◽  
Wael Goravey ◽  
Abdulatif Alkhal ◽  
...  

Abstract Background Human immune deficiency virus (HIV) infection remains a major health problem since discovery of the virus in 1981. Globally, since introduction of antiretroviral therapy, AIDS related death felt by more than 25% between 2005 &2011. Also, HIV related opportunistic infections (OIs) are less common, especially with use of prophylaxis to prevent such infections (3). We aim in this study to assess the incidence of HIV infection and related OIs in Qatar for 17-year period, and assess the spectrum of these infections, risk factors and treatment outcome. Methods retrospective cohort study for all HIV infected patients registered in Qatar from 2000-2016. Incidence of HIV infection and related opportunistic illness was calculated per 100000 population. Demographic and Clinical characteristic were compared between two groups of patients with and without opportunistic illness. Results of 167 cases with HIV infection 54 (32.3%) of them had opportunistic illness. The average incidence rate of HIV infection over 17 years is 0.69 per 100000 population, and the incidence rate for opportunistic illness is 0.27 per 100000 population, figure1. The most common opportunistic illness is pneumocystis jirovecii pneumonia (PCP) 25% of cases, followed by CMV retinitis 7.2%, Tuberculosis 5.4%, Toxoplasmosis 4.2% and less than 2% for Kaposi sarcoma, lymphoma and cryptococcal infection.


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